On Sept. 11, 2001, Sylvie Rosenbloom rushed down from her home in Scarsdale to St. John’s Medical Center in Yonkers an hour after the first airplane hit the World Trade Center. She was off that day, but reported to work in case they needed the hands of an extra emergency department nurse.
Now she’s seeing her fellow medical profession members go all in again during the COVID-19 pandemic, a different type of threat facing the world. Nurse Appreciation Week kicked off Wednesday and nurses are certainly earning their due.
“I’m definitely very appreciative of the nurses and the docs and respiratory therapists and all those professionals that are on the front lines taking care of the patients,” Rosenbloom said.
Rosenbloom DNP, FNP-BC, CDCES, a nurse practitioner since 1996, may not be on the front lines, but she’s doing her part at Stamford Health Medical Group, where for the last four years she’s been treating patients in the walk-in office. In March, the walk-in department was screening patients and seeing them, but with the realization that the virus was spreading more rapidly later in the month they stopped seeing anyone with a respiratory complaint at the group, instead referring them to Stamford Health hospital, which had a dedicated section for potential coronavirus patients. “Then we stopped seeing primary care patients and as things got worse we resorted to telemedicine,” Rosenbloom said.
Three weeks ago when the walk-in department was temporarily shuttered, Rosenbloom was placed in charge of an important task for her group: making sure that anyone with a non-COVID-related issue — there is a COVID hotline for employees — was healthy. That meant physicals for new employees, taking care of on-the-job injuries and general non-COVID health.
“Now they want to slowly reopen, so we’re still going to do more telemedicine and I think we’re going to start seeing patients soon, but they are still going to be screening the patients,” Rosenbloom said.
That means a different look for waiting rooms upon return. The appointments will be spaced out more and patients will have the option of waiting in their cars to receive a phone call when it’s their turn. Masks will also be required. There are major changes coming as a result of the pandemic and this is only the beginning.
Rosenbloom earned an associates degree in computer science in Canada before moving to the United States, where she opted to go back to school for nursing. She had wanted to be a doctor as a teen, so she would finally be able to make an impact in the medical profession. “Computers was just machines and boring and I’m more of a people person,” she said.
Rosenbloom got her nursing degrees from Pace University in Pleasantville in 1994 and 1996 and went back to school in 2015 to get her doctorate from Sacred Heart University. “I’m a doctor nurse,” she said.
Her first job was in a nursing home as she graduated to a “saturated market,” and when she got her master’s as a nurse practitioner she worked in the St. Joseph’s emergency department for a decade. Tired of working holidays and weekends and with her two children getting older — they are 21 and 16 now — Rosenbloom joined the Riverside Medical Group’s internal medicine and cardiology department for seven years before heading over to Stamford.
The Stamford walk-in center is still primary care, not an urgent care center. If a patient is sick or has a medical need and the primary physician is unavailable, they make an appointment with Rosenbloom. Though she gets to know the patients in the practice well, as the walk-in nurse practitioner she doesn’t get to follow up on each patient’s issue as they are likely to see the physician next time around.
“The thing that stands out the most, or what patients have told me, is that I explain things so well, better than the docs,” she said. “We don’t use those medical jargon terms, so usually the patients come out understanding what we’ve taught them.”
As a nurse practitioner she has extra training beyond that of a registered nurse so she can examine patients, order tests and prescribe medications.
“What I find the most rewarding is when I provide education for the patients and they have an aha moment and you see they understand and they go home and change their diets and take the medicine, whatever you’re educating them,” she said. “Then they come back and they see results, whether it’s improved blood work or weight loss. They’re very happy about that and I find that very rewarding.”
Another plus for Rosenbloom is the scheduling flexibility that allows her to teach at Sacred Heart, impacting the next generation of registered nurses and nurse practitioners, for the last six years.
“When you see them in the clinical setting and they learn how to approach the patients and learn to complete a physical exam and talk to them and then they come back to you and they discuss the patient and then they’re able to start to come up with a plan for the patient,” Rosenbloom said. “That’s very rewarding to see that they’re learning and I actually did teach them something.”
From her kids’ education and experiences to her own teaching to her regular duties in Stamford during the pandemic, Rosenbloom is eager to return to real life, but she knows this isn’t over yet for those in her profession.
“It’s sad, but hopefully it’s taking a turn for the better in the next few weeks,” she said. “People want to get out and go back to normal, but then there will be an increase and nobody knows what the fall is going to bring.”
Down the road
At White Plains Hospital, nurses are an integral part of the work done year-round and, like those around them, they have stepped up their game to do what is needed during the pandemic. The hospital has treated more than 1,000 patients so far as part of the Westchester County epicenter.
Lauren Brancucci has been working at WPH since she was 17 years old. She got her nursing degree at College of New Rochelle while working in the WPH intern program and has been on staff for six years, the last three in critical care and the ICU.
Until two months ago, heading to work was somewhat routine. Brancucci, who lives in Rye Brook, knew just about everything she’d be doing each day.
“We were used to caring for a critically ill patient population and dealing with high stress situations, but we always had it kind of slow and knew what to expect when we went to work,” she said. “Now during this crisis you go into your shifts not knowing at all what’s going to happen. I’ve never worked in such a high-stress, high-pressure environment before and I’ve never dealt with sicker patients in my life compared to what we used to do. Everything has completely changed in this for sure… It’s a huge risk to us intubating patients and this causes aerosolizing droplets, which puts us at risk.”
Pre-COVID-19, WPH had 16 critical care beds and two ICUs, with the ability to add beds if there was overflow. Now there are 82 beds and five ICUs, more nurses were brought in and others were deployed from other departments to handle the severe coronavirus caseload. “We’ve been very full and we’ve almost used all of the 82 beds at the peak,” Brancucci said.
It’s causing the nursing staff to adapt what they’ve been doing, in some cases for decades, to tackle a situation that has potentially deadly consequences for both patients and staff. The already strong teamwork has been taken to a new level with everyone leaning on each other for support.
“We go into our shifts ready to do this, ready to help the patients, ready to help each other and constantly be willing to learn,” Brancucci said. “Because it’s such a new virus we’ve all had to tailor our practices to meet the needs of the patients and what’s going on with them at the moment. The senior nurses are changing what they’ve done for maybe 30 years to try to best take care of these people.”
With patients who are to be put on ventilators entering the hospital alone and being sedated for the duration until they are able to breathe on their own — if that ever happens — it’s a very different feeling at the hospital as the staff has no communication with the patients. Not only are video calling apps of personal use to nurses like Brancucci, who hasn’t seen her family in eight weeks, but for when patients do come out of sedation and are extubated.
“We can show a family a person that’s been extubated after maybe three weeks on a ventilator and seeing how relieved they are and how happy they are — it makes everything worth it for sure,” Brancucci said.
The outpouring of support for WPH from surrounding communities has also lifted the workers’ spirits with three meals a day, plus letters, cards and artwork from children that lines the hallways. “That gives us the extra little push we need to get through our shifts,” Brancucci said.